Vijaya Guduri
Individual provider Active NPI Internal Medicine Physician · Hollywood, MD
NPI 1386825271 · NPPES record last updated Dec 13, 2023
Key facts
- NPI
- 1386825271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- D0068923 (MD)
- Practice address
- 24035 Three Notch Road
Shah Associates MD LLC
Hollywood, MD 20636 - Phone
- (301) 373-7100
- NPI assigned
- Nov 19, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 26
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kaiser Foundation Health Plan of the Mid Atlantic States, Inc
Practice addresses (Care Compare)
13285 Minnieville Rd
Woodbridge, VA 22192-4018
Phone (703) 986-2400
2391 Greenspring Dr
Timonium, MD 21093-6038
Phone (301) 816-2424
Hospital & facility affiliations
- University of MD St Joseph Medical Center
- Luminis Health Anne Arundel Medical Center, Inc
- University of MD Baltimore Washington Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MD, VA, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091023000482 | MD | Practitioner - Hospitalist |
1759428766 | Reassigns benefits to 6 organizations |
| I20240103002725 | VA | Practitioner - Hospitalist |
1759428766 | Reassigns benefits to 2 organizations |
| I20240110005154 | DC | Practitioner - Hospitalist |
1759428766 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0068923 | MD | MD | Internal Medicine Physician |
Practice roles
Locations
904 Commerce Rd
Annapolis, MD 21401
Phone (410) 849-6140
2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366
2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601
7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600
7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700
301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565
1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000
10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100
1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500
655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100
2101 E Jefferson St
Ste 4EPFS
Rockville, MD 20852
2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853
2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852
2101 E Jefferson St
#4E
Rockville, MD 20852
2391 Greenspring Dr
Timonium, MD 21093
Phone (410) 847-3000
6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000
1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500
2200 Kernan Dr
Woodlawn, MD 21207
Phone (410) 448-2500
8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400
14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000
13285 Minnieville Rd
Woodbridge, VA 22192
Phone (703) 986-2400
Interoperability endpoints
- vguduri265294@direct.umm.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D0068923 | MD | Yes |
Addresses
Primary practice location
24035 Three Notch Road
Shah Associates MD LLC
Hollywood, MD 20636
Mailing address
PO Box 64522
Baltimore, MD 21264-4522
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Other providers in Hollywood, MD
- Lisa Early
- Kristin K Famiglietti
- Rajbinderpal Gill
- Amanda Gordner
- Greenwell Foundation
- Halappa Hakkal
- Harbor Bay Clinic of Chiropractic, LLC
- Brianna M Hardcastle
- John Harvey
- Helpstars LLC
All providers in Hollywood, MD · Internal Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.